[Surgical therapy of regional lymph nodes in cancers of the lower lip].

Based on a retrospective follow-up study of patients with lower-lip carcinoma from 1968 to 1980, the incidence of metastases of such lesions was broken down according to tumor classification, and the survival rates for these patients were computed. In the total group of 89 patients with primary surgical treatment of the tumor and lymph nodes, 17 (19.1%) were found to have metastases. Among these tumors, 5 were classified as T1, 10 as T2, and 2 as T3. Analysis of the survival rate yielded the following results. To date, there has been no recurrence in any of the patients who underwent suprahyoid lymph-node removal with no histological evidence of lymph-node metastases. Of the 17 patients in whom histological lymph-node metastases were identified in the submandibular region following primary suprahyoid neck dissection, 64.7% showed no evidence of disease for 5 years on average, and all are still alive. In contrast, 90% of the patients died in whom the primary tumor was just treated locally and who did not undergo radical removal of the suprahyoid lymph-node until secondary metastases had occurred. In the light of our experience, suprahyoid lymph-node removal appears to be indicated as part of the primary treatment of lower-lip carcinoma, independent of the prevailing tumor stage. This may not apply to tumors that are clearly less than 1 cm in size.